激光辅助陶瓷托槽去粘接对牙釉质及牙髓不良影响的Meta分析-《中国医学物理学杂志》

文章信息/Info

Title:: Adverse effects of laser-aided ceramic brackets debonding on enamel and dental pulp: a Meta analysis

作者:: 孙立众1; 2; 王若帆1; 2; 王琳璇1; 2; 王琦1; 2; 马文强1; 2; 韩梅2; 米方林1; 2; 孙立众1，2，王若帆1，2，王琳璇1，2，王琦1，2，马文强1，2，韩梅2，米方林1，2

Author(s):: SUN Lizhong1; 2; WANG Ruofan1; 2; WANG Linxuan1; 2; WANG Qi1; 2; MA Wenqiang1; 2; HAN Mei2; MI Fanglin1; 2; 1. Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China; 2. North Sichuan Medical College, Nanchong 637000, China

Keywords:: ; laser; ceramic brackets; adhesive remnant index; pulp temperature

摘要:: 目的：对激光辅助陶瓷托槽去粘接后牙釉质及牙髓不良反应进行Meta分析。方法：计算机检索The Cochrane Library（2017年12期）、PubMed、CBM、CNKI、万方数据库，搜集激光辅助陶瓷托槽去粘接后牙齿表面粘接剂残余指数及牙髓温度变化的相关研究，检索年限均从建库至2017年12月。由两位研究者独立筛选文献，提取资料并评价纳入研究的偏倚风险后，采用Stata 12.0进行统计分析及Revman 5.3进行亚组分析。结果：激光辅助陶瓷托槽去粘接影响牙面粘接剂残余指数纳入7个研究，激光影响牙髓温度纳入6个研究。Meta分析结果显示：陶瓷托槽去粘接前使用激光进行照射与否对于去粘接后牙面粘接剂残余指数的大小无显著作用[MD=0.074, 95%CI(-0.472~ 0.619), P=0.791]；相反，激光照射可以显著提高牙髓温度[MD=3.69, 95%CI(2.71~4.66）, P=0.000]，且合适的激光参数设定对牙髓无不可逆性的损伤。结论：激光应用于陶瓷托槽去粘接对于牙面上的粘接剂残余指数无明显影响，但会导致牙髓温度升高。

Abstract:: Objective To perform a Meta analysis for evaluating the adverse effects of laser-aided ceramic brackets debonding on enamel and dental pulp. Methods We searched The Cochrane Library (2017, No.12), PubMed, CBM, CNKI, WanFang Database from inception to December, 2017 for collecting relative studies about the adhesive remnant index and pulp temperature after laser-aided ceramic brackets debonding. Two reviewers independently screened literatures, extracted data and assessed the risk of bias of included studies. Stata 12.0 was applied for statistical analysis and Revman5.3 for subgroup analysis. Results The effect of laser irradiation on adhesive remnant index was searched in 7 studies while pulp temperature in 6 studies. The results of Meta analysis revealed that the pooled-mean difference (MD) and 95% confidence interval (95%CI) for continuous variables of adhesive remnant index with or without being affected by laser before ceramic brackets debonding were [MD=0.074, 95%CI(-0.472-0.619), P=0.791], and that laser irradiation significantly improved the pulp temperature [MD=3.69, 95%CI(2.71-4.66), P=0.000]. Moreover, the laser irradiation with appropriate parameters didn’t cause any irreversible injuries to pulp. Conclusion The laser applied in ceramic brackets debonding has no significant effects on the adhesive remnant index but leads to an increase of pulp temperature.